Ellen Koltz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008708 Issued in VA

Practice address

2603 Nine Mile Rd
Ste 220
Richmond, VA 23223

Phone

(804) 266-2222

Fax

(804) 281-8535

NPI assigned

Aug 14, 2018

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1881174415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639969",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 NINE MILE RD",
            "address_2": "STE 220",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23223",
            "telephone_number": "804-266-2222",
            "fax_number": "804-281-8535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8500 Executive Park Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220312228",
            "country_code": "US",
            "telephone_number": "804-572-7962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLTZ",
        "first_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bharadhwaj Kolipakkam, MD
• Miriam Koller Pizzani, MD
• Roger Alan Koller
• Prashanta Bharadwaja Kolluru, M.D.
• Haley Kolos
• Kathleen Ryer Komornik, OD
• Daniel J Komorowski, M.D.
• John A. Komtopanos Jr., DDS
• Matthew Kona, M.D.
• Andrea Konadu Agyapong, FNP-C

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.